Skeptics with a K: Episode #043

In this fracking episode of Skeptics with a fracking K, Mike, Marsh and Colin talk about a Christian’s view of fracking atheists, the effects of religiosity on your fracking mortality, and an earthquake in fracking Blackpool. Plus, Jonah, homeopathy on the Wirral, General Zod and (of course) fracking.

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Just because the technique of prescribing is quite tricky and most people including homeopaths make blunders in this aspect, thinking that homeopathy is useless is a big mistake.
even babies and animals respond wonderfully to correctly prescribed remedies.this alone sufficient to tell its all not just placebo. And I have seen a partially drowned puppy with just two or three breaths per minute and beyond any pain or sensation brought to life very fast after a dose of opium followed by carbo veg as soon as breathing became quicker.
Since the properties & behavior of fundamental particles are not yet fully understood, brushing aside such wonderful healing system on the ground that ‘the remedies are too dilute to have even a single molecule of the medicine’ may prove to be one of the historical blunders of mankind like the execution of Socrates and house imprisonment of Galileo for telling the truth ! Everybody is not a scientist just by learning science, a real scientist comes only one in a billion.

In response to venkatesh. How inane to quote that old chestnut, “they laughed at Galileo” or similar dumb refrain. We know a lot about fundamental particles. We can predict how they will react to any physical actions. In fact it is the most accurate theory in science and can predict with the accuracy of 1 in 10 billion. Homoeopathy is bullshit and you know it. The drowning dog was saved not by homoeopathy but by being ‘taken out of the water’ natch! No fairy dust required.

Mike :
We aren’t “brushing aside” homeopathy because it is too dilute. We’re brushing it aside because controlled trials unambiguously show that it does not work.
If it could be shown to work reliably through controlled trials, even if we did not understand the mechanism of action, no skeptic would be campaigning against it.

he 2009 The British Medical Journal (BMJ) Best Health Project looked at 2500 commonly used medical treatments, 46% of these had no “scientific basis”, and their use was based on habit, doctors or patient preference. Worse 10% were unlikely to work, be ineffective or actually harmful. A review of data submitted to the US Food and Drug Agency in support of licensing application for antidepressants found that these were no better than placebo and if unpublished data was included there was no significant effect.

As I’ve said before – as in all medical traetments its the experience of the patient that matters

I’m not sure what you’re quoting that data for? It doesn’t support your point.

I also disagree that its the experience of the patient that matters. Efficacy and safety are baselines. Any intervention should be able to show those two things before any other consideration, in my view.

Mike :
We aren’t “brushing aside” homeopathy because it is too dilute. We’re brushing it aside because controlled trials unambiguously show that it does not work.
If it could be shown to work reliably through controlled trials, even if we did not understand the mechanism of action, no skeptic would be campaigning against it.

he 2009 The British Medical Journal (BMJ) Best Health Project looked at 2500 commonly used medical treatments, 46% of these had no “scientific basis”, and their use was based on habit, doctors or patient preference. Worse 10% were unlikely to work, be ineffective or actually harmful. A review of data submitted to the US Food and Drug Agency in support of licensing application for antidepressants found that these were no better than placebo and if unpublished data was included there was no significant effect.

The most important evidence – as in all medical treatments – is the experience of the patients.That is the most effcetive criteria to assess the use of any treatment. If it makes a person feel better why shouldn’t it be used.

Because some interventions can make you feel better without you actually getting better. Given the option between being made to think your better and actually getting better, which do you think most patients would prefer?

I quote the data because it shows that if you want to base medicine on the ideals of “efficacy and safety”, then nearly half of commonly used medical remedies would fail the standard. Just because a drug or procedure can be shown to work under ideal, controlled conditions (i.e. its efficacy), doesn’t necessarily mean it will be effective or even safe under real conditions. The recent 10:23 campaign very nicely demonstrated the safety of homeopathy to the world.

Don’t forget that, apart from fixing broken bones, cutting out bad bits and other physical therapies, a lot of medicine is about helping the patient to cope with the symptoms of the illness until the body repairs itself. So yes I would much rather feel better because I know that I am getting better.

I quote the data because it shows that if you want to base medicine on the ideals of “efficacy and safety”, then nearly half of commonly used medical remedies would fail the standard.

Right. And what does that have to do with whether homeopathy works? The fact that other medicines are also rubbish has no bearing on the question. Even if every single licensed medicine was absolute nonsense, that doesn’t make homeopathy a valid intervention. This is a total red herring.

The recent 10:23 campaign very nicely demonstrated the safety of homeopathy to the world.

No-one is arguing that homeopathy isn’t safe. Of course, it is safe, it is inert. It is only dangerous when it is used instead of medicine, for life-threatening conditions. But safety alone is not sufficient to justify the use of an intervention.

Don’t forget that, apart from fixing broken bones, cutting out bad bits and other physical therapies, a lot of medicine is about helping the patient to cope with the symptoms of the illness until the body repairs itself.

Yes, this is very true, a lot of medicine is about that. But homeopaths don’t restrict themselves offering placebo treatments for self-limiting conditions, do they? No they go around telling people they can cure malaria, HIV and cancer.

So yes I would much rather feel better because I know that I am getting better.

That isn’t what I asked. Let me restate more explicitly.

If you gave a patient the option of a) an inert intervention that will do nothing at all, except perhaps fool them thinking they’re getting better; or b) an active intervention that will actually help them get better – which do you think they will chose? I’d stick my money on the latter.

It’s worth mentioning that “alternative” medicine falls into one of two categories. It’s either been shown not to work, or it;s not been shown to work. If it has been shown to work, it stops being alternative, and just becomes medicine.

Homeopathy, at this point in time, looks to be firmly in camp 1, it has been shown not to work.

This is why is is talked ill of. It’s been researched ad nauseum, and the conclusion is that it is about as efffectivve as intercessory prayer, witchcraft, or faith healing.

There are many randomised controlled trials, and met-analyses of such trials that show the efficacy of homeopathic treatments for a range of conditions, just as there are for many conventional therapies.

However, are RCTs a good indication of the effectiveness or even the efficacy of a treatment I quoted the data because it shows even based on conventional scientific methodology nearly half of some 2,500 commonly used medical treatments had no scientific proof that they worked. But, as I’m sure you’re aware, work by such people as Ioannidis is showing the inherent problems in this type of study. His work published in the Journal of the American Medical Association estimates that between a third and half of such research could be plain wrong.

Living systems are very complex; add in human psychology and the mix gets even worse. Diseases are often aggregates of symptoms, or a “cluster” of symptoms. RCTs tend to cherry pick candidates, with closely defined criteria for acceptance in a trial. Theoretically this is to enable like for like comparison, but in reality does nothing to answer how well the treatment will work in the real world.

My point is that it is the patient’s experience of the treatment that matters. If I get ill, go to a practitioner and given a treatment, if that treatment makes me better, then as far as I’m concerned that treatment is effective. Its also effective in economic terms, I can return to work, I don’t need to see the practitioner again etc. The government funded CAM Project in Northern Ireland showed the importance of patient experience as a measure of the effectiveness of particular therapies.

What staggers me is that the NHS has been in operation for over 50 years, yet has never kept this type of information. During an illness last year I was quoted figures from a 5 year old clinical trail, despite the fact that the busy department in which I was being looked after had actually treated more people with the disease in the last 5 years that were included in the clinical trail. This has to be one of the greatest failings of medical science in this country.

I will also jus point out; I’m not an advocate of Homeopathy or any other therapy. I have taken homeopathic remedies and they worked for me, I also know people for whom it also worked.

As to your last point:
If you gave a patient the option of a) an inert intervention that will do nothing at all, except perhaps fool them thinking they’re getting better; or b) an active intervention that will actually help them get better – which do you think they will chose? I’d stick my money on the latter.
Given my recent experience with drugs and pharmaceutical I will take a) every time because as you know most treatments are just there to mask or control the symptoms while the body gets on with getting better

I’m sorry Nick, are you actually trying to say that RCTs can’t show efficacy?

As regards to your final point – once again you dodge the question. I didn’t say anything about a pharmaceutical. And nor did I say anything about masking symptoms. Nor, actually, did I even ask what you personally would do.

Once again:

If you gave a patient the option of a) an inert intervention that will do nothing at all, except perhaps fool them thinking they’re getting better; or b) an active intervention that will actually help them get better – which do you think they will chose?

Note: “active intervention that will actually help them get better”. Not something that masks the symptoms, nor (necessarily) a pharmaceutical drug.